Preventative mastectomy could be ended by breakthrough at Queen’s

Dr Kienan Savage QUB

Mark Rainey

Women at high risk of developing breast and ovarian cancer could avoid preventative surgery after a breakthrough by researchers at Queen’s University Belfast.

Many women who carry what is known as the BRCA1 mutation – such as actress Angelina Jolie – opt for a double mastectomy rather than live with the knowledge they have a well above average chance of developing the disease.

For around 1,000 women in the UK affected, the risk is up to 85 per cent for breast cancer and up to a 40 per cent chance of developing ovarian cancer.

Until now, a preventative mastectomy (breasts removal) and oophorectomy (ovaries removal) have been the only way of reducing the risk of developing both types of cancers.

However, the new discovery by the Queen’s Centre for Cancer Research and Cell Biology (CCRCB) may mean women affected with BRCA1 could use readily available drugs to reduce their risk of developing the disease, rather than having to undergo irreversible surgery.

Such treatments would then open up the possibility that some of these women, who might otherwise opt for an oophorectomy, could still be able to have children.

The new research by Dr Kienan Savage and Professor Paul Harkin at CCRCB finally proves there is a direct link between high levels of oestrogen and DNA damage, which causes cancer, in the breasts and ovaries.

Specifically, the Queen’s researchers discovered that the cells of women with the BRCA1 mutation cannot effectively fight the very high levels of oestrogen that exist in all women’s breasts and ovaries, leaving them vulnerable to DNA damage.

The link between oestrogen, breast/ovarian cancer and BRCA1 mutation has been suspected by the scientific community for years but only proven now.

Dr Savage, who led the research, said: “This discovery is very significant in the management of women with the BRCA1 gene mutation. It’s the first really credible evidence that oestrogen is driving cancer in women with a BRCA1 gene mutation.

“Because of this discovery, we now have the opportunity to propose an alternative treatment to surgery.

“It also opens up the possibility of pausing treatment for a period in order for women to have children, if desired.”

Dr Savage added: “What also makes this exciting is that there are drugs already on the market which turn off oestrogen production. In theory, we could use these drugs to chemically reduce oestrogen production in women which could negate the need for irreversible surgery.”